With federal authorities and private insurers cracking down on healthcare fraud in 2022, Corporate Investigation Consulting is now offering healthcare audit defense consulting services backed by decades of federal healthcare fraud enforcement experience.
Dallas, TX – Corporate Investigation Consulting, a federal compliance and defense consulting firm headquartered in Dallas, Texas, has announced the launch of its Healthcare Audit Defense practice. The firm reports an increase in healthcare fraud enforcement activity in 2022, and its Healthcare Audit Defense practice is devoted exclusively to helping providers and other businesses avoid penalties during audits conducted by the Centers for Medicare and Medicaid Services (CMS), private health insurers, and other entities.
According to Roger Bach, a member of Corporate Investigation Consulting and a former Justice Department healthcare fraud investigator with more than 30 years of relevant experience, “Now more than ever, doctors and others in the healthcare industry need to be prepared to defend against billing compliance audits.” Mr. Bach continues, “During these inquiries, auditors are examining years’ worth of providers’ billing records, and they are looking for any excuse to impose recoupments and other penalties.”
Mr. Bach indicates that while audits have always been a concern for healthcare providers and other businesses that bill Medicare, Medicaid, Tricare, private health insurance, and other payors, the current volume of healthcare fraud in the United States has forced the government and private insurers to make billing compliance a priority. “Healthcare fraud costs Medicare alone tens of billions of dollars annually. While most doctors and businesses in the healthcare industry have no intention of overbilling, bad actors have forced payors to cast a wide net with their enforcement efforts.”
While bad actors face the greatest risks during healthcare audits, Mr. Bach notes that upstanding providers can face risks as well. “A key fact about healthcare audits—and a fact that many doctors and executives do not realize—is that even unintentional billing errors can lead to allegations of fraud.” With this in mind, Mr. Bach says that all healthcare entities need to take audits very seriously, and they need to be prepared to defend themselves with documented compliance programs and substantiating records for all scrutinized billings.
Corporate Investigation Consulting is headquartered at 4131 N. Central Expressway, #900, Dallas, TX 75204. For more information, call 866-352-9324 or visit www.corporateinvestigation.com.
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